Frequently-asked questions answered: Priory addiction expert Dr Niall Campbell on the surge in cocaine use
- “Increased use is partly linked to the stresses of modern living and the pandemic We see lives wrecked by it”, says Dr Campbell
- Its use has become “normalized”
- In lockdown, people used it “to self-medicate for depression”
- Cocaine addiction poses a “significant challenge to the health system”
The number of people contacting the Priory for help with cocaine addiction has doubled. Enquiries about private treatment surged 100% between June 2020-2021 (up from 278 to 556).
We sat down with Priory consultant psychiatrist, and UK addiction expert, Dr Niall Campbell, based at Priory’s Roehampton Hospital, to understand a fuller picture of cocaine abuse and cocaine addiction symptoms:
Priory data shows a 100% rise in those inquiring about private treatment for cocaine addiction in the year to June 2021. Are you seeing female patients too?
“We do see women but it’s more men. The increase in cocaine use during lockdown was from people trying to self-medicate for depression with cocaine but it’s an evil drug and a very bad anti-depressant. It’s also still the number one ‘party’ drug, people want it as an ‘upper’ much more than amphetamines and MDMA. It’s still regarded as fashionable. It’s regarded as ‘cool’. Its use has become normalised. It’s on the table after the dinner party. We see female lawyers, bankers, consultants, people in the media, all sorts – it has also got cheaper. Women tend to do it more in a party situation than men. Men are more solitary users, women are doing it more socially. Both drink more, and doing coke makes you able to drink more. It counteracts the sedative effects of alcohol and seems to make people want more alcohol.”
National statistics show an explosion in cocaine use in recent years, with a rise in cocaine-related deaths. What are you seeing?
“Cocaine use is prevalent across classes and used by all levels of society. It poses a significant challenge to our health system. People want an instant anti-depressant, and they think cocaine is it, but it absolutely isn’t. We see lives totally wrecked by it.”
What is behind its surge in use?
“Increased use is partly linked to the stresses of modern living and the pandemic. People either have two jobs or no job, so they become exhausted and get depressed and some people now working from home find their relationships with their families have become increasingly fractious; that’s often when they use cocaine. They want to keep using it because of the highs, and then need to keep using it because of the ‘downers’, so cocaine leads to serious addictions, leading people to come to places like the Priory for help. People may start taking it socially and then doing it on their own and it just spirals; their life turns into a car crash.
How prolific is it?
“Cocaine can be delivered to the door as fast as a pizza. People will often have ‘euphoric recall’ about their pre-lockdown drinking or drug use, and now feel the need to be even more intoxicated, or behave more recklessly. People think it’s victimless, which the drug trade absolutely isn’t - they care more about where their coffee comes from than where their cocaine comes from.”
What sort of people are becoming addicted?
“People are working from home, doing two jobs or no job, people are being asked to take on more responsibility and increased demands. Bosses want more and more out of people.”
How has the jobs market fuelled this – are more people worried about job and working from home/jobs cuts?
“There is more unemployment in certain sectors like the travel industry, financial industries, hospitality. Companies are letting people go. Both people without jobs, and those who are having to make staff redundant, suffer high levels of stress and that can fuel cocaine addiction. Some people I see have felt devastated laying people off, or seeing something they have invested in and built up for years come crashing down.”
How are they accessing cocaine?
“People tell me that in certain parts of London, cocaine can be delivered by dealers in as little as 10 minutes via car. It can be delivered faster than a pizza. It’s said to cost around £50 to £60 a gram, and is reasonable quality as dealers want to keep their customers. A heavy user might use 2/3 grams in a night, depending how much cocaine is in it. People access cocaine on the dark web but often it’s just a coded phone conversation to a dealer. I am seeing patients as young as 18 up to the age of 65. Teens start on alcohol and sometimes have got drunk to the point of amnesia. They don’t start on marijuana anymore, they have a drink and some coke. If they hang around with risk-taking party types, they are more likely to start using themselves. The peer pressure is all there.
“Some older people have used other drugs in earlier years and then thought 'what's the harm of doing this?'”
What are the health impacts?
“There are serious - sometimes fatal - consequences to the heart, and to your mental state.
“You can have a cardiac arrest, you can have a stroke, and of course it affects your liver and the way you think and feel emotionally. It's a depressant drug after all. The irony is that people want an instant anti-depressant, and they think cocaine is it, but it absolutely isn't. If people could spend 10 minutes with the patients I see whose lives have been ruined by cocaine, they would think differently.”
According to the Drug Misuse in England and Wales report from the Office for National Statistics (released December 2020), powder cocaine is the second most commonly used drug in the last year among adults aged 16 to 59 years. Among young adults aged 16 to 24 years, powder cocaine was the third most commonly used drug, behind cannabis and nitrous oxide.
Anyone who would like help addressing their drug use should contact their GP, Narcotics Anonymous, or a provider like the Priory which offers free addiction assessments at many of its rehabilitation hospitals and Wellbeing Centres across the UK.
Acceptance
“Changing a difficult situation isn't always possible. So, accept what you cannot change and focus on the things you do have control over - such as regularly connecting with colleagues over video conferencing or online meetings.
Use music
“Put on headphones to listen to music can have many benefits, such as helping you relax and focus on something away from work and the outside world. Turn off rolling news and social media platforms such as Twitter, and just check in once a day. Stretch your legs and take a walk, even just to the garden, the kitchen or another room in your house before returning to your desk. Moving around and changing your environment, even slightly, can clear your mind and re-energise you.”
Coping with panic
Dr Donna Grant, consultant psychiatrist at Priory Hospital Chelmsford, offers some tips to help cope with panic at this time:
“Observe your thoughts and tell yourself that your mind is reacting to these thoughts and anxiety. These feelings are
normal - it's just the body's alarm system doing its job when it doesn't need to.
“Learn to control your breathing. People often hyperventilate during a panic attack. This means taking deeper breaths than normal which results in you feeling short of breath, causing a feeling of dizziness, disorientation and chest pains. By learning to slow your breathing down, you can help prevent the uncomfortable physical symptoms and stop the panic cycle. Try to get a slower and more stable breathing rhythm by breathing in for three seconds, holding your breath for two seconds, and then breathing out for three seconds. As you breathe, ensure that your stomach expands as you take each breath as this helps to ensure the breathing isn't shallow, which can add to the problem.
Learn to use positive coping statements
“When you are feeling anxious and panicky it can be helpful to have 'coping statements' which can be used to remind you that panic is not dangerous and isn't harmful.
Such statements could be:
- Panic is simply high levels of anxiety
- By remembering these symptoms are nothing more than anxiety, I can prevent further symptoms occurring
- My anxiety and panic will pass naturally given time. It doesn't last forever
Reminding yourself of these facts can help to prevent further panic cycles happening.
Keep a journal
Pamela Roberts, a Priory psychotherapist based at Priory’s Woking Hospital, adds that for those who might be self-isolating: “Ensure you are working in a well-ventilated room and following basic self-care, so healthy eating, sleep, lots of hydration, and try to keep to a routine. Set up a ‘buddy group’ with family or friends and regularly check in online or with Facetime.
“If you feel low, journaling can be a helpful way to unload emotions. Go with the flow. Tell yourself ‘what I am doing is enough’. Be good to yourself. If you have slept badly, accept you'll be in a low, more anxious mood. Your energy will be low. Try and relax and focus on positive things knowing that every effort is being made globally to bring this situation to a close, but it will take time. Being able to relax will help you through. When you're tense you tend to dwell on things and make them worse. If you are able, get into your garden and get daily doses of sunshine. Maybe look at some free online courses offered by the Open University. The mental health charity Mind has some very useful advice on self-isolating and your mental health. For support with grief, anxiety, or mental wellbeing, you can call or text an organisation like the Samaritans, or you can access therapy online with a trained therapist.”
Tapping
Priory expert Steve Clarke, a psychotherapist and hospital director at the Priory¹s Life Works Hospital in Woking, Surrey, explains EMT: ‘Emotional Freedom Technique (EFT) - Repetitive finger tapping can sometimes help to release negative emotions such as anxiety. It has been called a psychological version of acupuncture in that it involves making contact with a number of acupuncture points. The specific points to tap are the end-points of the major meridians (meridians are believed to be channels of subtle energy which flow through our body). So, whilst focusing on your negative emotion you tap on a meridian point (collarbone, under the arm and top of the head try to avoid the face at these times) three to seven times, repeating your negative thought in your head. After each emotion, take a deep breath and exhale. Continue this until you feel calmer and relieved. When you feel more relieved, repeat the technique whilst you tap through a positive round, repeating more uplifting phrases.”
Nourishment
Dr Bijlani says: “Make time for a nourishing lunch with adequate hydration. Food and drink can greatly affect your physical and mental health. Stop working at the usual time you would if you had travelled to your office and then try and fit in some social calls to friends or family before you prepare your evening meal. Avoid drinking too much alcohol or eating unhealthy foods out of boredom. Try and keep to boundaries such as only drinking alcoholic beverages in limited quantities at the weekend. Having to spend endless time each day in our homes with others under the lockdown situation is certainly going to affect our relationships with them, regardless of whether they are our loved family members or not. Emotions can be “infectious” and if those around us aren’t able to keep calm and cope well, we could end up getting stressed, fed up, irritable or low ourselves. It’s important for each of us, where we can, to take responsibility for our own health so that we can help keep up a reasonable level of optimism and engender a healthy environment in our homes which we share with others. Try and do some things together, such as sharing the preparation and eating of meals and daily walks together while also maintaining respectful boundaries and giving each other space apart for private time alone. Work as a healthy community. Try and be sensitive, flexible and forgiving without losing your own sense of self or identity. The best way to keep your mood swings under control is to look after yourself by keeping to your usual routine of sleep, diet, exercise and other activities. If you have been prescribed medication for your mental health, then take it as advised.”
About Priory and MEDIAN
Priory is the UK’s leading independent provider of mental health services. We treat more than 70 conditions, including depression, anxiety, addictions and eating disorders, as well as children’s mental health, across our nationwide network of sites. We also support autistic adults and adults with a learning disability, Prader-Willi Syndrome and brain injuries, as well as older people, within our specialist residential care and supported living facilities – helping as many people as possible to live their lives.
Priory is part of the MEDIAN Group, one of Europe’s leading providers of high quality mental health and rehabilitation services. The MEDIAN Group comprises 290 facilities with 5,000 beds caring for 28,000 people in the UK, 120 facilities with 20,000 beds caring for around 250,000 patients in Germany, and 15 facilities with 2,000 beds caring for 13,000 people in Spain, with more than 29,000 employees overall.